Integrated care programs for patients with psychological comorbidity

A systematic review and meta-analysis

Lidwien C. Lemmens, C.C. M. Molema, Nathalie Versnel, C.A. Baan, Simone R. de Bruin

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Objective
Presently, little is known about the characteristics and impact of integrated care programs for patients with psychological comorbidity. The aim was to provide an overview of these integrated care programs and their effectiveness.
Methods
Systematic literature review including papers published between 1995 and 2014. An integrated care program had to consist of interventions related to at least two out of the six components of the Chronic Care Model. Programs had to address patients with psychological comorbidity, which is a psychological disease next to a somatic chronic disease. A meta-analysis was performed on depression treatment response and a best evidence synthesis was performed on other outcomes.
Results
Ten programs were identified, which mostly addressed comorbid depression and consisted of interventions related to three to five components of the Chronic Care Model. Meta-analysis showed significantly higher odds for depression treatment response for patients receiving integrated care (OR: 2.49, 95%CI [1.66–3.75]). Best evidence synthesis suggested moderate evidence for cost-effectiveness and for a beneficial effect on patient satisfaction and emotional well-being. Insufficient evidence was found for a beneficial effect on health-related quality of life, medication adherence, Hb1Ac levels and mortality.
Conclusion
There are few studies evaluating integrated care programs for patients with psychological comorbidity. Although these studies suggest that integrated care programs could positively affect several patient outcomes and could be cost-effective, additional studies are recommended to further assess the value of integrated care for this patient group. This is especially important since the number of people with psychological comorbidity is rising.
Keywords: Effectiveness, Integrated care, Meta-analysis, Psychological comorbidity, Systematic literature review
Original languageEnglish
Pages (from-to)580-594
JournalJournal of Psychosomatic Research
Volume79
Issue number6
DOIs
Publication statusPublished - 2015

Keywords

  • Effectiveness
  • Integrated care
  • Meta-analysis
  • Psychological comorbidity
  • Systematic literature review

Cite this

Lemmens, Lidwien C. ; Molema, C.C. M. ; Versnel, Nathalie ; Baan, C.A. ; de Bruin, Simone R. / Integrated care programs for patients with psychological comorbidity : A systematic review and meta-analysis. In: Journal of Psychosomatic Research. 2015 ; Vol. 79, No. 6. pp. 580-594.
@article{4dfce6f169244d9a90fcc1740f930f0b,
title = "Integrated care programs for patients with psychological comorbidity: A systematic review and meta-analysis",
abstract = "ObjectivePresently, little is known about the characteristics and impact of integrated care programs for patients with psychological comorbidity. The aim was to provide an overview of these integrated care programs and their effectiveness.MethodsSystematic literature review including papers published between 1995 and 2014. An integrated care program had to consist of interventions related to at least two out of the six components of the Chronic Care Model. Programs had to address patients with psychological comorbidity, which is a psychological disease next to a somatic chronic disease. A meta-analysis was performed on depression treatment response and a best evidence synthesis was performed on other outcomes.ResultsTen programs were identified, which mostly addressed comorbid depression and consisted of interventions related to three to five components of the Chronic Care Model. Meta-analysis showed significantly higher odds for depression treatment response for patients receiving integrated care (OR: 2.49, 95{\%}CI [1.66–3.75]). Best evidence synthesis suggested moderate evidence for cost-effectiveness and for a beneficial effect on patient satisfaction and emotional well-being. Insufficient evidence was found for a beneficial effect on health-related quality of life, medication adherence, Hb1Ac levels and mortality.ConclusionThere are few studies evaluating integrated care programs for patients with psychological comorbidity. Although these studies suggest that integrated care programs could positively affect several patient outcomes and could be cost-effective, additional studies are recommended to further assess the value of integrated care for this patient group. This is especially important since the number of people with psychological comorbidity is rising.Keywords: Effectiveness, Integrated care, Meta-analysis, Psychological comorbidity, Systematic literature review",
keywords = "Effectiveness, Integrated care, Meta-analysis, Psychological comorbidity, Systematic literature review",
author = "Lemmens, {Lidwien C.} and Molema, {C.C. M.} and Nathalie Versnel and C.A. Baan and {de Bruin}, {Simone R.}",
year = "2015",
doi = "10.1016/j.jpsychores.2015.07.013",
language = "English",
volume = "79",
pages = "580--594",
journal = "Journal of Psychosomatic Research",
issn = "0022-3999",
publisher = "PERGAMON-ELSEVIER SCIENCE LTD",
number = "6",

}

Integrated care programs for patients with psychological comorbidity : A systematic review and meta-analysis. / Lemmens, Lidwien C.; Molema, C.C. M.; Versnel, Nathalie; Baan, C.A.; de Bruin, Simone R.

In: Journal of Psychosomatic Research, Vol. 79, No. 6, 2015, p. 580-594.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Integrated care programs for patients with psychological comorbidity

T2 - A systematic review and meta-analysis

AU - Lemmens, Lidwien C.

AU - Molema, C.C. M.

AU - Versnel, Nathalie

AU - Baan, C.A.

AU - de Bruin, Simone R.

PY - 2015

Y1 - 2015

N2 - ObjectivePresently, little is known about the characteristics and impact of integrated care programs for patients with psychological comorbidity. The aim was to provide an overview of these integrated care programs and their effectiveness.MethodsSystematic literature review including papers published between 1995 and 2014. An integrated care program had to consist of interventions related to at least two out of the six components of the Chronic Care Model. Programs had to address patients with psychological comorbidity, which is a psychological disease next to a somatic chronic disease. A meta-analysis was performed on depression treatment response and a best evidence synthesis was performed on other outcomes.ResultsTen programs were identified, which mostly addressed comorbid depression and consisted of interventions related to three to five components of the Chronic Care Model. Meta-analysis showed significantly higher odds for depression treatment response for patients receiving integrated care (OR: 2.49, 95%CI [1.66–3.75]). Best evidence synthesis suggested moderate evidence for cost-effectiveness and for a beneficial effect on patient satisfaction and emotional well-being. Insufficient evidence was found for a beneficial effect on health-related quality of life, medication adherence, Hb1Ac levels and mortality.ConclusionThere are few studies evaluating integrated care programs for patients with psychological comorbidity. Although these studies suggest that integrated care programs could positively affect several patient outcomes and could be cost-effective, additional studies are recommended to further assess the value of integrated care for this patient group. This is especially important since the number of people with psychological comorbidity is rising.Keywords: Effectiveness, Integrated care, Meta-analysis, Psychological comorbidity, Systematic literature review

AB - ObjectivePresently, little is known about the characteristics and impact of integrated care programs for patients with psychological comorbidity. The aim was to provide an overview of these integrated care programs and their effectiveness.MethodsSystematic literature review including papers published between 1995 and 2014. An integrated care program had to consist of interventions related to at least two out of the six components of the Chronic Care Model. Programs had to address patients with psychological comorbidity, which is a psychological disease next to a somatic chronic disease. A meta-analysis was performed on depression treatment response and a best evidence synthesis was performed on other outcomes.ResultsTen programs were identified, which mostly addressed comorbid depression and consisted of interventions related to three to five components of the Chronic Care Model. Meta-analysis showed significantly higher odds for depression treatment response for patients receiving integrated care (OR: 2.49, 95%CI [1.66–3.75]). Best evidence synthesis suggested moderate evidence for cost-effectiveness and for a beneficial effect on patient satisfaction and emotional well-being. Insufficient evidence was found for a beneficial effect on health-related quality of life, medication adherence, Hb1Ac levels and mortality.ConclusionThere are few studies evaluating integrated care programs for patients with psychological comorbidity. Although these studies suggest that integrated care programs could positively affect several patient outcomes and could be cost-effective, additional studies are recommended to further assess the value of integrated care for this patient group. This is especially important since the number of people with psychological comorbidity is rising.Keywords: Effectiveness, Integrated care, Meta-analysis, Psychological comorbidity, Systematic literature review

KW - Effectiveness

KW - Integrated care

KW - Meta-analysis

KW - Psychological comorbidity

KW - Systematic literature review

U2 - 10.1016/j.jpsychores.2015.07.013

DO - 10.1016/j.jpsychores.2015.07.013

M3 - Article

VL - 79

SP - 580

EP - 594

JO - Journal of Psychosomatic Research

JF - Journal of Psychosomatic Research

SN - 0022-3999

IS - 6

ER -